Provider First Line Business Practice Location Address:
6001 TRUXTUN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 320C
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-663-9094
Provider Business Practice Location Address Fax Number:
661-663-9098
Provider Enumeration Date:
12/19/2007